Balancing Diabetes and Celiac Disease

Max Bruno, a freshman at the State University of New York at New Paltz, tries to get to the gym about four times a week. He says that he knows his limits for working out, but likes to push himself.  “I just have to be careful,” he explains. “About an hour or so after I’m done working out, my blood sugar drops really low.”

Max was diagnosed with type 1 diabetes in January 2010. He found out after being tested for celiac disease, for which he also tested positive. “I’d been having stomach problems since the sixth grade,” Max explains. “Frequent trips to the bathroom, throwing up, general pain, stuff like that.”

An autoimmune condition, celiac disease is caused by an insensitivity to gluten. The term “gluten” encompasses all forms of wheat and some forms of rye, barley, and oats. As Max sardonically puts it, “If it tastes good, I probably can’t have it.” If left untreated, celiac disease can lead to other conditions, such as anemia. It remains unclear what role Max’s celiac disease played in his developing diabetes.

Being diagnosed with one of the conditions would have been hard, Max says, but finding out he had both at the same time was brutal. “I was really angry. I just kept thinking, ‘Why me?'”

Max began using insulin pens after being diagnosed, but switched to a pump within a few months. Gluten-free foods typically have higher carbohydrate counts, which forces Max to use extra insulin in order to manage his blood glucose levels. “Since I switched [to the pump] last summer, I don’t have to stick to such a strict eating schedule,” he says. “I still have to be careful about what I eat, but it gives me more flexibility as to when I do it.”

Unlike most of his peers, Max has to monitor everything he eats, a difficult task on a college campus. A typical day’s diet at school includes gluten-free Rice Chex with milk at the dining hall for breakfast, a microwaveable gluten-free pizza for lunch, and then grilled chicken and vegetables for dinner.  “I snack a lot—crackers, fruits, gluten-free bagels, stuff like that,” he says. “But I get really tired of eating the same things every day.”

Having both conditions has obviously had a tremendous impact on how Max lives his life and how he views things. “Physically and mentally, I’m a completely different person than I was a year and a half ago. I’m way more cautious about things than I used to be. I have to be.”

Max admits that it took him a while to adjust to having his conditions and that he still struggles with that. Aware of the consequences of neglecting his health, however, he is determined to live a normal and healthy life. “I think of it as a Venn diagram,” he says with a smile. “There’s the diabetes on one side, the celiac on the other. And I’m in the middle, trying to take care of both.”